Healthcare Provider Details

I. General information

NPI: 1427973395
Provider Name (Legal Business Name): MS. MEGAN AMBER MISKINIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5465 GRAND AVE STE 101
GURNEE IL
60031-4913
US

IV. Provider business mailing address

377 BELLE PLAINE AVE
GURNEE IL
60031-2907
US

V. Phone/Fax

Practice location:
  • Phone: 224-303-4395
  • Fax: 224-241-3154
Mailing address:
  • Phone: 224-303-6495
  • Fax: 224-241-3154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: